Homestead_Tepe (6)a/, E CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
..;� State Form 5473 (R2 / 5 -92)
Deli
INSTRUCTIONS: See reverse side for filing instructions.
' M NlJ,flw2_O certify
as our principal place of residence the following described k-al property for which a Homestead
FORM YEAR
�H 10
,- .4
MR 2 7 1QQIZ-
ch, 19
hereby claimed:
ff l(We)owned ❑ Are buying under contract -
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
CONTRACT RECORDED
It buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
' PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
PROPERTY DESCRIPTION
County
Township
�reby certify the above statements are true, correct and complete.
Taxin 'strict (city, town, township) .
C1b orI
�o})
Parcel number
Legal description
- I D'Li
Pt gW
3 1- 3 o
It any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
Residential improvements
' PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
�reby certify the above statements are true, correct and complete.
i^alure of aimant
Address (number and street. dry, stale. ZIP code)
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON. RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Otherland
(2)
Total land (line I plus line Z)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pf/s line 7)
I (6)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Dare signed
�fying action -Signature of Auditor
Date signed
19_Pay 19_
Lesser of 112 Homestead
Valuation or $2,000
DEDUCTION ALLOWANCE
3
signed [�
alIEiOtSt 5ta,R`/Rwr TRFASUIfRfORV:}la
.ArrMrwEn BYsr1t WHIM nF.VYI*.\TS,sn MIST-TUBED DY 1111 DrMRneu OFux:m.GOVERNMENT FaeANCElc.-1.1-r-l.l
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple-.are limited to one homestead standard deduction.As the receipt of this deduction become,
more beneficial,there is more incentive than ever for homestead fraud homestead fraud causes higher Is'bills for all:therefore.
IAEA 134-1-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying infumnmon necessary to allow county government to better monitor homestead
filing.This information will he Lyn confidential and can only he accessed by authnri,ed county officials.The Depannlenl of
Local Government Finance will use this informition to create Owls that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Tepe, Donald F/Kristi L
R3 Box 207 13
ity IN
9293
Donald F/Kristi L Tepe
9603 S 1225E State Parcel Number Legal Description
Oakland City IN 47660-7814
II III II II I II I III III II I II 26-21-31-200-001.724-001 001-01724-00 PT W NE 313819.03 AC
u
f tat L tat a rat rat a me t o II N k D-19 PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Dona lC{I /1'rG r∎k rare_
g Address(number and street.city,state,and ZIP P code) - ___ _ — Same as property address- - —__ _ _ _ _
1(003 5 RxS C DRk\anctel 4-' ) to y7(00 0
Spouse First Middle Last
� �
r 5\--c Lynne- +e -eke
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
9(oo3 S 1 se Qaklancf CJJ-11t Le7460
Each undersigned certifies,under penalty of perjury.that the above and foregoing information is true and correct and that he or she is eligible to
receive the homestead standard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions
unlawfidly,he or she may be liable for back taxes and substantial financial penalties.
Owner I Date
PART 4:ADDITIONAL INFORMATION
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1
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